Endoscopic surgery has recently become a widely practiced surgical procedure. One type of endoscopic surgery, laparoscopic surgery, generally involves a small incision such as through the navel and abdominal wall to view or operate on organs or tissue located in the abdominal cavity. A camera or lens is placed in the area to aid the surgeon in guiding the endoscopic instrument to the particular area to be observed or operated upon.
Endoscopic instruments typically have a handle, an elongated shaft section and any one of a number of surgical tools attached to the shaft. The tools attached to the shaft are referred to as "end-effectors" and may include, for purposes of reference and not exclusion, needle holders, graspers, dissectors, cutters, and scissors. The movement of the end effectors are typically controlled at the proximal end of the instrument by manipulating the handle or a control mechanism located on the housing or the shaft.
At present, most handle portions of endoscopic instruments are shaped in one of two configurations. The first handle configuration closely resembles the handle of a pair of scissors. The handles are ring-shaped and are fixed to close and open relative to one another such that the end effectors may be properly manipulated. The ring-shaped handles do not provide for any adjustability for variations in hand and finger size. Because the surgeon must place his or her fingers through the handle rings, if the span of the surgeon's fingers is too small or too big to fit between the rings, the surgeon is unable to maintain a proper and comfortable grip on the instrument. A second configuration of the handle portion of endoscopic instruments resembles a pistol grip. This style handle has a portion extending downwardly from the shaft. However, this configuration does not provide for any adjustability for variations in hand sizes. A surgeon with a large hand may find it uncomfortable or cumbersome to properly grip the instrument. Conversely, a surgeon with small hands may not be able to adequately grasp the handle so as to properly hold and support the instrument.
Neither the scissors nor the pistol grip configurations adequately address the needs of surgeons who all have various hand sizes, and grip styles when conducting surgery. There is at present no handle on an endoscopic instrument that adjusts relative to itself to accommodate variations in hand sizes as well as variations in grip styles. Because all users of presently existing endoscopic instruments must grip them in the identical fashion, many surgeons develop cramps or discomfort in their hands or backs after holding the instrument for a period of time. In addition, many surgeons must be forced to grip the instrument in a manner that is uncomfortable to them. Thus, it would be advantageous to have an endoscopic instrument that has adjustable handles to accommodate variations in hand sizes, and grip styles.
In addition, there is no existing endoscopic instrument capable of adjusting tile position of the shaft relative to the handle to accommodate different surgical procedures. There are many surgical applications for an endoscopic instrument. There are four general categories of surgery in which an endoscopic instrument may be used. These include thoracic, general abdominal, urological and gynecological.
With each of these categories of surgery, the shaft is angled with respect to the handle in a different manner. For example, in hernia surgery, the endoscopic instrument used forms an acute angle between the handle and shaft. The acute angle between the shaft and handle enables the surgeon to maneuver the endoscopic instrument through the navel and down the front portion of the patient's abdomen just below the skin to operate. With respect to general abdominal surgery, it is often most desirable to have an endoscopic instrument that has the handles and shaft perpendicular to one another. In gynecological surgery and procedures, the shaft and handle should typically be 180.degree. relative to one another.
As a result of different procedures, the preferred configuration of the endoscopic instruments used in each of these procedures is different. At present, a surgeon is apt to use a different endoscopic instrument for each of the procedures described above. This increases the cost of the surgery for the surgeon, the hospital, the insurance company and ultimately the patient. It would be beneficial for tile surgeon and all concerned to have a single instrument capable of adjusting the handles relative to the shaft that could be used for all surgical procedures described above. This would save surgeons, hospitals, insurance companies and consumers money on health care which continues to increase at a rate much higher than inflation.
Most prior art endoscopic instruments have end effectors that have moving parts such as hinges or linkages of some type. These end effector control linkages protrude from the body of the shaft when the end effector is controlled. This is undesirable because such protrusions tend to catch on tissue and cause unwanted damage. In addition, any deposits of tissue or bodily fluid in the linkage of the end effector make it difficult to clean, sterilize and reuse. It is desirable to have an endoscopic instrument that has end effectors that do not have any operating linkages that contact the patient. Such a feature would enable the end effector and instrument to be easily cleaned, sterilized and reused.
Thus, there is a need for an endoscopic instrument having handles that adjust to accommodate different hand sizes and different grip styles.
There is a further need for an endoscopic instrument having handles that adjust relative to the shaft for use in a variety of different medical procedures.
There is still a further need for an endoscopic instrument that enables the user to lock the jaws of the end-effector without maintaining pressure on the handles.
There is yet a further need for an endoscopic instrument where the operating linkages for the end effectors do not directly contact the patient.
There is an even further need for an endoscopic instrument that is cleanable sterilizeable and reusable.